Background: Urinary tract infections are the most common bacterial infections during pregnancy. Although asymptomatic bacteriuria is the most prevalent form of infection, acute pyelonephritis is the most serious complication, which occurs in 1% - 2% of all pregnancies as the leading cause of septic shock in pregnancy and related to increased risk of cerebral palsy.
Objectives: This study was performed regarding various results of previous studies and lack of a similar study to evaluate the prevalence of acute pyelonephritis and its outcomes in pregnant women admitted to Taleghani hospital, Tabriz, Iran.
Patients and Methods: All pregnant women admitted with acute pyelonephritis from March 2010 to October 2011 to Taleghani hospital, were enrolled in this study. Antibiotic therapy, urine cultures one or two weeks after treatment and late consequences such as pregnancy outcome, newborn birth weight and Apgar score were evaluated.
Results: The mean age was 23 ± 4.88 years. Of 60 patients, 40 (66%) were nulliparous and 19 (31.7%) multiparous. The mean gestational age was 25.73 ± 7.42 weeks. Most of patients (65%) had been diagnosed in the second trimester of pregnancy. Regarding urine culture studies, 42 (70%) had positive and 18 (30%) negative results. The predominant pathogen was E. coli isolated from 33 (78.6%) cultures, Klebsiella from 8 (19%) and negative coagulase staphylococcus from one (2.4%). None of the infants had low birth weight and 4 of them had preterm delivery (less than 37 weeks). The frequency of acute pyelonephritis was 0.46% in total deliveries.
Conclusions: Similar to previous studies, most cases diagnosed in the second trimester of gestation, which necessitates more investigation in this field, since timely diagnosis and treatment have a significant role in preventing known complications of the disease.
Keywords: Prevalence; Pyelonephritis; Pregnancy
Objective: Triage procedure is one of the most important aspects of emergency departments as it has an undeniable role on the management of patients. It includes 5 categories based on the Emergency Severity Index (ESI) according to the condition of severity. For better decision making and management, it is important to have skillful and experienced nursing staff. In the current study, we aimed to investigate the effectiveness of a one-day workshop on participants in terms of their triage knowledge improvement.
Methods: This is a pre- and post-test trial study. In this study all the nursing staff of Sina hospital participated. The workshop was conducted in a single day for 6 hours. During the one-day workshop, topics such as emergency triage and hospital triage were covered according to START and ESI. In order to evaluate triage knowledge, each participant completed a pre-test before the workshop, and a post-test after the workshop (15 questions). Data were analyzed with SPSS 15.0. Paired t test was applied for data analysis.
Results: Fifty-five nurses with the mean age of 35.72 ± 7.35 participated in the workshop. The analysis of the data, using paired t test based on the pre-test and post-test results, did not show any significant differences (P > 0.05).
Conclusion: This study suggests that a one-day workshop is not really effective and reliable for triage knowledge improvement. We propose longer planned workshops in order to train more skillful staff.
Triage; Emergency department; ESI; START
Multiple trauma patients are always in higher risk of mortality and morbidity not only due their hazardous and life threatening injuries, but also because of missing injuries in clinical evaluations, examinations and workups. Several studies results evaluated during this review, that most of them provided that missed injuries are mostly due to lack of experience and skill in physicians while evaluating a trauma patients with multiple injuries in all three stages of trauma care process. This review proved the need for an instruction and guideline to evaluate injuries most likely to be missed in trauma patients to prevent further complications and mortalities.